Research Summary

Academy Title:Swank2011
Research Article: Prehabilitation before total knee arthroplasty increases strength and function in older adults with severe osteoarthritis.
“Prehabilitation” refers to exercise before surgery to help reduce functional decline after surgery. The theory is that a higher level of function pre-operatively will provide a higher level of function post-operatively, thus shortening the rehabilitation process. Prehabilitation exercise has been shown effective at preventing functional decline in frail elderly individuals (Gill et al. 2002).

Dr. Robert Topp and his colleagues at the University of Louisville have been researching the effects of a “prehab” program for patients scheduled for total knee replacement surgery for the past 4 years. Their exercise program features progressive Thera-Band resistance over 4 to 8 weeks before surgery.

Most recently, Dr. Topp’s colleague, Dr. Ann Swank was the lead author on paper in the February 2011 issue of Journal of Strength and Conditioning Research. The article described the pre-operative outcomes of 71 patients with severe knee arthritis with pain that didn’t respond to medication. The patients were randomly assigned to either a control group or a 4 to 8 week prehab exercise group prior to total knee replacement surgery.

Patients were tested before and after the program that included progressive Thera-Band resistance band training, light walking, stretching, and step-up training, three times per week in the clinic and at home.

The exercise group improved their pain levels significantly more than the control group. They also significantly increased in leg strength and improved their performance on functional tasks. The authors concluded that their short-term and “easily accessible” prehabilitation program was successful for patients with end-stage knee osteoarthritis and pain unresponsive to medication.

Dr. Topp noted, “The prehabilitation program we developed using Thera-Band resistance for total knee replacement patients reduces pain and improves function before surgery. It’s quite possible that this program can translate to savings in healthcare costs.”

REFERENCE: Swank AM, Kachelman JB, Bibeau W, Quesada PM, Nyland J, Malkani A, Topp RV. Prehabilitation before total knee arthroplasty increases strength and function in older adults with severe osteoarthritis. J Strength Cond Res. 2011 Feb;25(2):318-25.

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